RZs are scheduled for recipients in current payment status and in N01 payment status who are 1619(b) eligible.

Scheduled RZs are based on an error profiling system that determines the case's likelihood of a change in circumstance.

RZs are required to reinstate benefits and pay any withheld benefits for class members in the Martinez court case settlement . (For information on Title XVI Post-2006 Martinez Settlement Relief Processing, see GN 02613.875). The profile code is “S” (High Error Profile) and the selection indicator in the case redetermination data (CRZD) field on the SSR is “J” . (For parts of the CRZD Segment on the SSID Record, see SM 01501.002.)

Following is the frequency with which RZs are scheduled:

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  Annually if a change in circumstance is likely.

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  Once every 6 years if a change in circumstance is unlikely.

RZs are not scheduled if the recipient is in a medical institution and limited to a $30 payment cap, unless there is likelihood of ineligibility or erroneous payments.

RZs are not scheduled for Title VIII, Special Veteran Benefits (SVB) cases.

Instructions on the selection and processing of Medicare Part D Redeterminations are located in HI 03050.011.

Field office personnel conducts RZs.